Bite of Blood Safety Flashcards
What is environmental health
The theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations
What are the five different aspects of environmental health
- Relationship between people and environment
- Systems-based, ecological approach
- Others focus on environemtnal conditions, controlling hazards or health-promoting environments
- chemical and physical hazards
- Social and built environments
What is the naylor report
Preparndeness are practiced by progessionals in our community espiclaly in relation to emerging infectious diesease, globalization and bioterrorism
Provides a frameowrk fo renewal of public healthh
What started the Naylor Report
The SARS crisis in the early 2000s
What is VBD
Infections that are transmitted to humans through the bite of an inficeted arthropod such as mosquito or tick
What diesease come form mosquito
West nile virus
Eastern Equine Enchpalitis
Zika
What diseases come from ticks
Lyme disease
What is in an important factor of VBD
Amplification factor
What is the West Nile Virus
Recognized in Africa in 1930s
Circulates between birs and bird-biting mosquitos
What are bridge vectors
Species of mosquitos that transmit the virus from birds to humans or horses
When was west nile first decteted
New york 1999 and spread across most of North America
When did WNV become of public health significance in Ontarion
2003
Is WNV a serious disease
Only for some of the population 80% are asympompatic and even smalelr of the population has inflammation of the brain and brain stem usually in immunocomporised and older people
What else effects the WNV
Climate and weather dependent dry summer fewer mosquitos in general hot wet summer more favourable for mosquitos
What year is always higher for ammount of disease
The first year because we do not know what we are dealing with
What are some aspects to understand when framing this problem
Nature of the condition - Potential or available test - alternative policy option
Risk to blood supply
Zero tolerance - precautionary principle
Cost of doing something vs not doing something
What is the precautionary principle
The idea that if people are harmed and you didn’t do anything you could get sued so you do something about it and try and reduce the ammount of harm
What is the rio declaration 1992 Pirnciple 15
In order to protect the environment the precautionary approach shall be widely applied by States according to their capabilites. Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for posponing cost-effective measures to prevent environmental degradation
What are the 5 precautionary principle principles
Proportionality
Non-discrimination
Consistency
Examing costs and benefits
Subject to review
What is proportionality
You don’t want to kill a fly with a hand grendae it is proprotional to people that are not harmed
What it is non-discrmination
Comparable situations should be treated in the same way unless there are grounds for doing so
What is consistency
Measures should be of comparable scope/nature that are already taken and if it works then you can apply it
What is examing costs and benefits
Comparing costs of actions and lack of action in both the short and long term not just an economic cost-benefit analysis
What is subject to review
In light of new scientifc data you take all measures possible but as you learn more it starts to change
When is the precuationary principle accepted
By the population
Typically supported by the population when the hazards are well established and understood by the population when there are gasps it can be convertisoral
Whaat is risk management science
The systematic scientific identification evaluation and prioritzation of risks of adverse health effects resulting from human or environmental exposure to hazardous agents or situations and the economical application of resources to minimize monitor and control the probality and or impact of the adverse events
Data is constantly evaluates risks are stratified and costs are considered
Not always the obvious thing
Prevents the risk from becoming a hazard
Some cases we can not get ourselves away from the risk
What is part of the risk characterization
Site-specific information
Hazard identfication
Toxicity assessment
Exposure assesment
What are risk managment options
No further action
Emission control
Exposure control
remidation ( cleaning up the hazard)
Public Policy
Risk communication
(This is determined because of evaluation)
What is apart of the failure models and effects analysis
Steps in the process
Failure modes (what could go wrong)
Failuire causes (why would the failure happen)
Failure effects (what would be the consequences of each failure)
What is failure models
Proactive or reactive
Proactive
What are never events
Incidents or events called never event these things hsould never happen in health care so you have procedures to prevent never events (operating on the wrong limb)
What is FMEA
A way to proitize what to choose you want to deal with things that are severe and have a high occeurence could be less severe but have a high occeurence so you want to deal with it
Failure Modes and Effect Analysis
What is the krever commission
Public inquiry federal level that managed the threat of Hepatits C and HIV via lood traunfusion to make sure that this never happened again
Reformed blood system has a success how it keeps us safe
What caused the krever commission
Largest health catastrophe in Canadian history 1000 HIV and 30 000 Hep C via tranfusions in the late 1970s and 1980s
What are the two aspects of the report that were espically important
Precautionary measures and creation of a goverance system that priortizes safety
What are the difference between krever and naylor report
Naylor report examined the reactions to SARS krever was on the blood system so different public health issues
Naylor report looked at existing allocation of resobonsibilities of the goverment in health care
What is public health a concern for
Primary a provincial concer although it is actioned at the municipal level
What is fedral goverment responsible for
Authority to legislate aspects of public health over matters related to the maintenace of peace order and good goveremnt including quartine provisions and national borders and trade and commerce an interporvincial or international level
What did the Naylor report do with public health renewal
Focused on cordianation of the public level there is more money that flows more downard to deal with issues restruces and refines how public should work in canada
What is trade off
Many different diseases we could tackle there are not enough resources to accomindate them
What is true cost
What you give up to get it
Whos costs are included
Hospital
Health care system healthcare payer
health system ( costs in health and other sectors; transportation, social services)
Societal (all costs, inclduing patient costs)
Externalities
What are the three aspects of cost
Direct
Indirect - lost wages
Intagngible - pain suffering or opportunity
What is economic evaluation
The compartive analysis of alternative courses of action in terms of both their costs and consequences
What is opprotunity cost
We could have every program but usally we dont have the money to spend on all these programs we have to give up other programs
What are factors of economic evaluation
Always compartive
at least tow options are compared
Always involves costs
Each type measures consequences or outcomes in different ways
What is cost utility
You can compare three different types but focuses on value of life and the consequences
Can be opportunity cost be a conseqeunce value
YES
What is standard of care
What we are doing now or the status quo
What is cost analysis
How well does A work to B cost is the only difference
What is cost effectivness evaluation
Uses natural units such as life years gained premature births avoided bang for buck it is a ratio
What is the cost-effectivness plane
Comapare two health interventions along delta C change in cost and delta E outcome or your effects better as you go to the right the effects are better
What is the best spot in cost effective plane
A because it cost less than the orginal and is more effective than E than D and third is C
What is Cost utility Evaluation
Cost utility is using QALY and DALY
What is Health Utility tool
Used for cost utilitiy
1 is perfect health and 0 is death
How would you asses one year on the scale asking people who are healthy ask enough people the population as a whole one year and how they would feel with a condition
What is cost benefit analysis
Compare all cost and all benefits and tries to assign a dollar value to all of these thing
What are the issues of cost benefit analysis
Very comprehensive and diffuclt and ethical issues because assigning monteary values to life inherent biases also what makes a good life can varry CBA looks at maxmizing overall benefits which may overlook the eneds or rights of indviduals who are disproprotionately affected
What is cost analysis
Ethical
Very utilitarian also takes into deontological
